内膜斑块剥脱术治疗颈动脉狭窄的临床分析

目的 探讨颈动脉狭窄的手术治疗方法及疗效。方法 2006年2月至2015年7月采用颈动脉内膜斑块剥脱术（CEA）治疗颈动脉狭窄18例，所有病人均经颅脑多普勒超声检查或MRA筛选，头颈部CTA或DSA确诊，均在全麻下进行CEA。结果 术后临床症状改善17例，1例术后6 d死于大面积脑梗死。术后17例随访1~24个月，2例手术部位再狭窄（其中1例因反复短暂性脑缺血发作行支架治疗好转）；3例仍有短暂性脑缺血发作，保守治疗后好转；其余12例无明显并发症，恢复良好。结论 CEA是治疗颈动脉狭窄安全、有效的方法，对防治缺血性脑卒中有重要意义。

Clinical analysis of carotid endarterectomy for ischemic stroke

Objective To investigate the surgical method to treat carotid artery stenosis and its effect on ischemic stroke. Methods The clinical data of 18 patients with ischemic stroke due to carotid artery stenoses, who underwent carotid endarterectomy (CEA) from February, 2006 to July, 2015, were analyzed retrospectively. Of 18 patients aged 52~75 years (mean, 63.5 years) 11 were male and 7 female. The diagnosis of carotid artery stenosis was definitely made by head and neck CTA or cerebral DSA. Results The clinical symptoms including transient ischemia attack, weak limb muscle power and disturbance of memory and language were significantly improved in 17 patients after CEA and one patient died of massive cerebral infarction 6 days after CEA. Seventeen patients were followed up from 1 to 24 months, 12 were recovered well without conplications, 3 with postoperative transient ischemia attack were recovered well after conservative treatment and 2 with carotid artery restenosis (one was recovered well after the carotid artery stent vascoplasty). Conclusions CEA is a good method to treat carotid stenosis because it is safe and it can significantly improve the symptoms in the patients with cerebral ischemia due to carotid arteries stenoses.